1. Technical Field
The present disclosure relates to apparatus and method for localizing and removing tissue from within a patient's body. More particularly, the present disclosure relates to apparatus and method for localizing and removing breast tissue.
2. Background of Related Art
Numerous surgical instruments have been developed for localizing either tissue that needs to be removed or a surgical incision point for biopsy and/or excision of targeted tissue. Such instruments generally determine the coordinates of the surgery site or deploy a minimally invasive surgical marker which attaches to the tissue that needs to be removed. The latter instruments generally comprise a hypodermic needle or cannula which is inserted into the body and positioned adjacent to or in contact with the targeted tissue. A cable marker is then passed through the cannula and is anchored to the target tissue thereby marking it for subsequent surgical procedure, for example, excision or biopsy. Once the lesion is localized, the cannula is usually removed from the body, leaving the cable in place protruding from the body until such a time when the biopsy or excision is performed which usually requires transporting the patient to a surgical suite.
Various tissue localization systems have been proposed to aid in locating non-palpable lesions within the body and to prevent inadvertent dislodgement and/or migration of the needle. One such system includes a cannula needle and a wire guide made of a shape memory characteristic material which assumes a J-hook configuration. Such a device may be found, for example, in U.S. Pat. No. 5,011,473 to Gatturna which discloses a needle inserted into the body and advanced to localization of a lesion. Gatturna discloses a wire which is advanced inwardly allowing a J-hooked end to engage body tissue and immobilize the needle.
A surgical apparatus and method for localizing tissue location which prevents the marker from migrating is disclosed in co-pending U.S. application Ser. No. 08/546,483. This and other tissue localization procedures greatly reduce recovery time for the patients in comparison to conventional open surgical procedures.
Instrumentation is known for removal of tissue, particularly suspect tissue within the breast of a patient, once the tissue has been localized with a guide wire. Examples of such instrumentation is disclosed in U.S. Pat. Nos. 5,111,828; 5,197,484; and 5,353,804 each of which issued to Kornberg et al. Such devices, however, require that the localization needle be inserted prior to the insertion of the biopsy device.
As is quite often the case, lesions within the breast are non-palpable, therefore, making cancerous lesions more difficult to diagnose. Early diagnosis of suspect lesions in a patient's breast, however, has been greatly enhanced through the development of imaging machines, for example, stereotactic mammography imaging systems (hereafter referred to as "stereotactic machines"). In such machines, an elongated prone supporting examining table for x-ray mammography is provided with a central breast receiving aperture, through which the patient's pendulant breast is exposed to a horizontal beam of x-rays from a source which is angularly movable through an arc centered on the patient's breast. Thus, x-ray projection through more than 360 degrees around the patient's body is possible. An example of such a stereotactic machine is disclosed in U.S. Pat. No. 5,289,520 which issued on Feb. 22, 1994 to Pellegrino et al., the contents of which are hereby incorporated by reference.
Fine needle biopsy is also facilitated by stereotactic machines. In such procedures, doctors can take advantage of the precision instrument positioning and suspect tissue position locating capabilities of the machine's imaging systems, to precisely insert a biopsy needle and retrieve a tissue sample.
The advantages of utilizing minimally invasive instruments and procedures to perform biopsy or excision of tissue are clear. For example, damage to tissue surrounding the operative site is greatly reduced and hospital stays and follow up visits are also reduced. The enormous success of such instruments in procedures such as gall bladder removal and hernia repair has led to increased development of minimally invasive instruments for other operative procedures as well.
A need exists, however, for improved minimally invasive instrumentation and methods to localize and efficiently and efficaciously biopsy and/or remove tissue in the same surgical procedure so as to avoid following up with open surgical techniques if at all possible. The present disclosure provides a combined surgical localization and minimally invasive tissue removal apparatus which is relatively easy to use and inexpensive to reliably manufacture and use.